FAQ: Billing

Select to view all answers.

Will you bill my primary and secondary insurance?

You will need to provide us with complete primary insurance information. As a courtesy to our patients, we will submit bills to your insurance company and will do everything possible to advance your claim. Physician and Center charges will be included on one bill. However, it may become necessary for you to contact your insurance company or supply additional information to them for claims processing requirements or to expedite payment.

Do you provide estimates for my course of treatment?

Yes. However, it is only an estimate, which is based on your individual course of treatment.

Are itemized statements automatically sent to patients?

Itemized billing statements are not automatically sent to patients. If you would like to receive an itemized statement, please call the Billing department at (805) 898-2191.

Why am I receiving a refund check?

There was an overpayment to your account. Either you paid too much on the account and/or your insurance paid at a later date and covered some of what you already paid.

Why did my insurance deny the claim?

One or more of the following may apply:
The service you received was not covered under your plan.
You did not provide the correct insurance information at the time of service.
The service you received was from a physician outside your plan’s network.
You were not covered by your plan at time of service.
Your primary care physician did not process a referral for the services or an authorization was not obtained prior to the services being rendered.

Once you begin radiation treatments, you may walk straight back to the Radiation Therapy department to check-in for your daily appointments. When you are scheduled for a follow-up or post-treatment appointment, you must check in with the front desk in the main lobby, 300 West Pueblo Street.

Why is there an error on my bill?

If you have questions about your bill, or believe that it is incorrect, call (805) 898-2191. Confidential voice mail is available after hours, and your call will be returned on the next business day.

What is a co-payment?

A co-payment is a set fee the member pays to providers at the time services are rendered. Co-pays are applied to office visits, emergency room visits, hospital admissions, etc. The costs are usually minimal. The patient should be aware of the co-payment amounts prior to the date of service.

What is a deductible?

Deductibles are provisions that require the member to accumulate a specific amount of medical bills before benefits are paid. For example, if a member’s policy contains a $500 deductible, the member must accumulate and pay $500 out of pocket before the insurance carrier will pay benefits. Once the patient has met their deductible, the carrier usually pays a percentage of the bill. The patient is liable for the unpaid percentage. Deductibles are yearly, usually starting in January.

What is co-insurance?

Co-insurance is a form of cost-sharing. After your deductible has been met, the plan will begin paying a percentage of your bills. The remaining amount, known as co-insurance, is the portion due by the patient.

Why did my insurance company only pay part of my bill?

Most insurance plans require you to pay a deductible and/or co-insurance. In addition, you could be responsible for non-covered services. Please contact your insurance company for specific answers to your questions. You may have out-of-pocket expenses.

Why do I need to call the insurance company if they do not pay the bill?

If you have a PPO policy, you are ultimately responsible for the total bill or any portion of the bill your insurance carrier does not pay. The Patient Finance Office will make every effort to resolve the account balance with your insurance carrier. Occasionally, we will be unable to resolve the issue with your carrier and will need your assistance.

If I have an HMO policy, can I be billed if they do not pay?

If you have an HMO policy, you should only be billed for the amount specified on your explanation of benefits (EOB) that is provided to you by your insurance carrier. This usually includes co-pay amounts, deductibles and non-covered services.